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Breastfeeding Your Baby

Introduction:

This booklet is for new mothers who wish to breastfeed. It is information on how to get started and how to avoid common problems. There is also information on expressing your breast milk. We have referred to the baby as “he” in order to avoid confusion.

Once established, breastfeeding is easy and for most a very enjoyable experience. In the first few days you both need to learn what to do. You need to practice and, if necessary, get help and advice from your health advisor.

If you have started to formula feed your baby and want to switch to breastfeeding, this is still possible but it is not always easy.

Remember:

YOUR breast milk is perfect for your baby and adapts to meet your baby's changing needs. Most babies need no other food or drink until they are six months old.

Why is breastfeeding so special?

Breast milk contains antibodies to protect your baby from infection. Sickness and diarrhoea (gastroenteritis, which may be very serious), chest, ear and urine infections are all more common in formula- fed babies.

Breastfeeding continues to benefit your baby as he grows. Research suggests that breastfed babies have better mental development. Children who were formula fed as babies are at greater risk of eczema and diabetes and tend to have higher blood pressure than those who were breastfed.

Breastfeeding is also good for mothers. It helps you lose the weight gained during pregnancy. It can help protect you from breast and ovarian cancer and give you stronger bones in later life.

The following information helps to make a good start.

Breastfeeding benefits

1. Protection against diarrhoea and tummy upsets

2. Protection against chest infection and wheezing

3. Protection against ear infections

4. Lower risk of diabetes, raised blood pressure and heart disease in later life

5. Better mental development

6. Less smelly nappies

7. Less eczema

8. Better mouth formation

9. Stronger bones in later life

10. Lower risk of early breast cancer

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Putting your baby to the breast

Your position

It is important that you find a comfortable position.

If you are sitting down to feed, make sure that:

Your back is straight and supported
Your lap is almost flat.
Your feet are flat ( you may need a footstool or thick book), and
You have extra pillows, if needed, to support your back and arms or to help raise your baby to the level of your breast.

Breastfeeding lying down can be very comfortable. It is especially good for night feeds as you can rest while your baby feeds.

• Try to lie fairly flat with a pillow under your head and your shoulder on the bed.

• Lie well over on your side. A pillow supporting your back and another between your legs can help with this.

• Once your baby is feeding well, you will be able to feed him comfortably anywhere without needing pillows.

• Your baby's position – For breastfeeding there are various ways to hold your baby.
Whichever way you choose here are a few guidelines to make sure that your baby is able to feed well.

• Your baby should be held close to you – “tummy to mummy”

• He should be facing the breast, with head, shoulders and body in a straight line.

• His nose or top lip should be opposite the nipple – “nose to nipple”

• He should be able to reach the breast easily, without having to stretch or twist.

• Remember always to move your baby towards the breast rather than your breast to the baby.

So:

Turned - Tummy to Mummy

Nose to Nipple

Baby to breast, not breast to baby

Attaching your baby to the breast

It is important to make sure that your baby latches on to the breast properly - otherwise he may not get enough milk during the feed and your nipples will become sore.

Position your baby as described: with his nose or top lip opposite your nipple.

Wait until he opens his mouth really wide (you can gently brush his lips with your nipple to encourage him to do this).

Quickly move him onto your breast, so that his bottom lip touches the breast as far away as possible from the base of the nipple. This way, your nipple points towards the roof of his mouth.

When your baby is properly attached to your breast you notice that:

• His mouth is wide open and he has a big mouthful of breast.

• His chin is touching the breast

• His bottom lip is curled back.

• If you can see any of the areola (the brown skin around the nipple), more is visible above his top lip than below his bottom lip, and

• His sucking patterns change from short sucks to long deep sucks with pauses

Feeding should not be painful. While you and your baby are learning to breastfeed you may feel some discomfort when the baby first attaches to the breast. This sensation should fade quickly and then the feed is comfortable. If it continues to hurt, this probably means that your baby is not attached properly. In this case, take him off by gently pressing your breast away from the corner of his mouth so that the suction is broken and then help him to re-attach. If the pain continues ask for help.

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Tips for successful breastfeeding

Try to keep your baby near you, particularly at first. That way you get to know him well and quickly know when he needs feeding. This is especially important at night. If you have your baby next to you, you can easily lift him for feeding without either of you being disturbed too much. You can then both return to sleep more quickly.

Breastmilk contains all the food and water your baby needs for the first six months. Giving other food or drink could be harmful and may also make him less interested in breastfeeding. If he does not breastfeed often enough you may not make enough milk to meet his future needs. Therefore, whenever he seems hungry, just put him to the breast.

Most of the problems, commonly experienced by breastfeeding mothers in the first few weeks (for example, sore nipples, engorgement, mastitis) occur either because the baby is not attached to the breast in the best way or because he is not being put to the breast often enough. Ask for help if you are unsure.

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Patterns of Breastfeeding

Babies' feeding patterns vary enormously. For example, some babies do not want many feeds in the first day or two. However, feeds may then become very frequent, particularly in the first few weeks. This is normal. If you just feed your baby whenever he seems hungry, you produce plenty of milk to meet his needs. This is because each time he feeds, messages are sent to your brain, which then sends signals to your breast to produce more milk.

More feeding = More signals = More milk

Each time your baby feeds, the milk supply is being built up.

While he is learning, his feeds may also be quite long. Many mothers worry that frequent feeding means that they have not got enough milk to feed their baby. Providing that the baby is properly attached to the breast, this is very unlikely to be the case. Ask for advice if you are unsure.

Once you and your baby are used to breastfeeding, it is usually very easy.

The milk is always available at just the right temperature. In fact, there is really no need to think about it at all. Your baby lets you know when it is time for the next feed

Your breastfeeding is going well when:

• He is alert and waking for feeds,

• He has a minimum of 5-6 wet nappies and 2 soiled nappies per day after the first week.

• He is gaining weight after the first week,

• He settles and sleeps at some times during the 24 hours! and

• Your breasts or nipples are not sore.

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CONTINUING TO BREASTFEED

Breastfeeding need not stop you and your baby going out and enjoying life.

You can breastfeed almost anywhere. If you wear loose clothing and you are discreet, you can feed without worry. You may feel uncomfortable at first but soon find you get more confident. Most people will not notice you are breastfeeding - try practicing in front of the mirror at home.

Your baby may have hungry days when he needs to feed more often for a day or two to build up your supply. Feeding your baby whenever he is hungry allows your milk supply to catch up with his needs quickly.

Remember: More Feeding= More Signals=More Milk

You may want to go out sometimes without your baby, or you may be returning to work before you want to stop breastfeeding. It is possible to express milk for your baby so that someone else can feed him.

Do not be tempted to introduce your baby to solid foods before he is ready.

All babies are different. At some time around six months, your baby begins to reach out and grasp things and put them in his mouth. He is able to stay sitting upright at this point. These are signs that he is beginning to be ready for solids.

Breastfeeding alone provides all the food and drink a baby needs for the first six months and it protects against a range of illnesses. Many mothers breastfeed much longer than this; breastfeeding benefits you and your baby for as long as you both wish to continue.

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EXPRESSING YOUR BREASTMILK

Why you may want to express your milk

• if you need your baby attach to a full breast

• if your breasts feel full and uncomfortable

• if your baby is too small or sick to breastfeed

• if you need to be away from your baby for more than an hour or two

• if you are going back to work

Methods of expressing your milk

There are three main methods of expressing breastmilk.

• By hand

• By hand pump

• By an electric pump

Whichever method you choose, the milk may take a minute or two to flow when you start expressing. Milk can be continuously expressed from one breast only for a few minutes before the supply slows down or appears to stop.

Milk should then be expressed from your other breast.

Go back to the first breast and start again.

Keep changing breasts until the milk stops or drips very slowly.

Colostrum, the first milk in your breast comes in very small amounts because your baby's tummy is small. This first milk is extremely valuable to your baby.

As your breast milk develops the supply of milk increases.

Encouraging your milk to flow:

• Try to be as comfortable and relaxed as possible. Sitting in a quiet room with a warm drink may help.

• Have your baby close by. If this is not possible have a photograph of your baby to look at instead – this is especially helpful if your baby is sick in the Special care Baby Unit.

• Have a warm bath or shower before expressing; you may want to apply warm flannels to your breast.

• Gently massage your breast. This can be done with your finger tips or by rolling your closed fist over your breast towards the nipple. Work around the whole breast, including underneath. Do not slide your fingers along your breast as it can damage the skin.

• After massaging your breast gently roll your nipple between your first finger and thumb. This encourages the release of hormones, which stimulate your breast to produce and release the milk.

• As you get used to expressing your milk you will find that it takes less time. Just like breastfeeding, it gets easier with practice.

Hand Expressing

This is a free and convenient way of expressing milk and is particularly useful if you need to relieve an uncomfortable breast. These instructions are a guide but the best way to learn is to practice (perhaps in the bath) so that you find what works for you.

TECHNIQUE FOR HAND EXPRESSING

Each breast is divided into around 15 sections or lobes, each with its own milk ducts. It is from these ducts that you express the milk. It is important that you rotate your fingers around the breast to ensure that milk is expressed from all the lobes,

Place your finger under the breast towards the edge of the areola and your thumb on top of the breast opposite the first finger (you may be able to feel the milk ducts under the skin) - your finger and thumb will now be in a C shape. If you have large areola, you may need to bring your fingers in slightly from the edge (if your areola is small, you may need to move them out slightly). Your other fingers can be used to support the breast.
Keeping your fingers and thumb in the same places on your skin, gently press backwards towards the chest wall.
Maintaining this gentle backwards pressure, press your thumb and first finger together and so easing the milk along the ducts and toward the nipple. You should not squeeze the nipple as this is not effective and could be painful. Be gentle and careful not to slide your fingers along the breast as this can damage the delicate breast tissue.
Release the pressure to allow the ducts to refill and then repeat steps 2 and 3.

Once you have the “knack”, steps 2 and 4 take no more than a few seconds. You are able then to build up a steady rhythm. This results in the milk dripping and perhaps spurting from the breast.

Hand Pumps

There are a number of different designs, all of which work in slightly different ways. Some are operated by hand and some by battery. They all have a funnel that fits over the nipple and areola. Different pumps suit different women - it is therefore best, if at all possible, to try out a pump before buying.

Electric Pumps

These are fast and easy because they work automatically. They are particularly good if you need to express for a long period, for example if your baby is in the Special Care Baby Unit. If this is the case, then you should try to express a minimum of 6-8 times in 24 hours, including once during the night, to maintain your milk supply.

It is possible to express both breasts at the same time using some electric pumps that have a dual pumping set. This is quicker than other methods and may help you to produce more milk.

Follow the manufacturer's instructions very carefully if you use a hand or electric pump.

Whichever method you choose it is important that you wash your hands thoroughly . All ontainers, bottles and pump pieces must be washed in hot soapy water before each use and sterilized if your baby is newborn, very young or in hospital.

STORING BREASTMILK AT HOME

Breast milk can be stored in the coolest part of a refrigerator at a temperature of 2-4”C for up to 5 days. If you do not have a refrigerator thermometer, it is probably safest to freeze any breast milk that you do not intend to use within 48 hours.

Breast milk can be stored for one week in the ice compartment of the refrigerator; up to three months in the freezer section of a fridge freezer with separate doors, or 6 months in a chest freezer. If you have a self –defrosting freezer, store the milk as far away as possible from the defrosting element.

When freezing breast milk for occasional use at home, any plastic container can be used providing it has an airtight seal and can be sterilized. Remember to date and label each container and use then in rotation.

If you are expressing breast milk because your baby is premature or sick, ask those who are caring for him for advice about how to store your milk.

Frozen breast milk can be thawed slowly in a refrigerator.

Frozen breastmilk can also be thawed by standing the container in warm water.

Thawed breast milk can be stored in a Refrigerator and used for up to 24 hours.

Once it has warmed to room temperature, it should be used or thrown away.

Breast milk should never be re-frozen.

IMPORTANT: Breast milk should NEVER be defrosted in a microwave because this may cause an uneven temperature and the milk may burn the baby's mouth.

For more information, please call Royale Hayat's Women & Family Health Advisor at 25360587.

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